Individual provider Active NPI

James Carnelia, PH.D.

  • Addiction (Substance Use Disorder) Psychologist
  • New York, NY
National Provider Identifier
1508987405
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X
License
009994 Issued in NY
Practice address
41 E 11TH St FL 4
C-O Washington Square Institute
New York, NY 10003-4602
Phone
(212) 472-5974
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X 009994 NY Primary

Addresses

Primary practice location

41 E 11TH St FL 4
C-O Washington Square Institute
New York, NY 10003-4602

Mailing address

38 E 81St St
Suite #5-B
New York, NY 10028-0216
Phone (212) 472-5974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170823003364 NY Practitioner - Clinical Psychologist 4183901929 Reassigns benefits to 1 organization
Practice locations: Briarcliff Manor, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1989
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1123 Pleasantville Rd
Briarcliff Manor, NY 10510-1603
Phone (914) 236-3636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
009994NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Community Health Centers, Inc. CurrentSince Apr 1, 2017 Accepting new patients
United Cerebral Palsy Associations of New York State, Inc. Current Accepting new patients
Metro Community Health Centers, Inc. CurrentSince Apr 1, 2017 Accepting new patients

Locations

979 Cross Bronx Expy
Bronx, NY 10460
Phone 71866575653009

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508987405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 E 81ST ST",
            "address_2": "SUITE #5-B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280216",
            "telephone_number": "212-472-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 E 11TH ST FL 4",
            "address_2": "C-O WASHINGTON SQUARE INSTITUTE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034602",
            "telephone_number": "212-472-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNELIA",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "009994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.